buddy hypo tonight,ok now

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Marci and Buddy

Marci and Buddy

Member Since 2009
have been remiss on posting,life hectic lately. Buddy's bg was 32 (after he ate),had FF HC.,now up to 52.
I read many times "shoot low to stay low", so at pmps he was 175,and i know he will only go up from there, i shot a 1.35,
which is maybe slightly less than .10 of his regular thin 1.5.....guess that was the wrong thing to do.
next time i'll shoot 1.25-does that soun d right?
 
Well, if he had a 32 you might consider 1.25U his new dose! There is sometimes the phenomenon that happens which is like the previous dose waving goodbye - about +3 or +4 they will have a sudden dip.

That is still pretty low, so warrants a dose reduction. Look at you go, giving him the HC and not posting here till after the fact. Good job. Did he display any symptoms like sudden hunger?

You might want to test him again before you go to bed. After an early low, I usually consider if they get up to at least an 80 they'll be fine after that. If it was a previous dose sign-off he probably won't go low again. Make sure he has food available.
 
good to know -thanks Vicky...yes, he was starving, he woke me up, which is how i knew he was hypo. i have had numerous experiences with him like this one, maybe about half a dozen in past 2 years, so i know how to deal,at least with the food part. i was very scared last night though, gave him a finger tip of corn syrup.This amps was red. Happy to hear you think his new dose is 1.25u, which is what i gave him. Hope he doesn't bounce too much.
 
That is my experience with low numbers too, Gandalf will "park" at the bowl and eat and eat. When he gets below 35 I usually break out some syrup. I don't worry unless it's below 35.

The bad thing about the resulting rebound BGs is that not only do they reflect the rebound, but also the extra carbs they get. Don't fret too much if he's in the 300s today.
 
i'm surprizingly pleased with his #'s today ,in the 100's. :smile:
I worry about him going hypo when i am gone all day-i know everyone here does too, i'm sure. have
not read about it actully happening though...has anyone?
 
Marci and Buddy said:
i'm surprizingly pleased with his #'s today ,in the 100's. :smile:
I worry about him going hypo when i am gone all day-i know everyone here does too, i'm sure. have
not read about it actully happening though...has anyone?
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Oh Buddy, you love to keep your Mama on her toes! :)

Good job Marci! And nice set of blue's today too! I hope the lower dose works well for him.

Did he eat well at dinnertime/shot time last night? Just wondering if that is why he went so low - if he didn't eat much.

I think everyone worries about that at one time or another, especially if they have picky eaters or a cat that has a propensity to go low for whatever reason. That is why a lot people for their peace of mind might leave food out when they are gone, or have automatic feeders. Sometimes cats might go low and bounce back and we don't even know it happened.
 
he did eat OK that night at pmps,but i should have known to give him a reduced dose based on his low #.
btw,vet said to monitor his teeth , not that he has any gum infections at this time,but will need a cleaning soon.Appears he is prone to have cruddy gums and teeth,and the whole process of sedation and testing and extraction and meds makes it so expensive. vet said to not give an aB as precaution b/c it lowers his immune system. as long as there's no infection now I think I will be in denial of
what may be later . ;-)
 
Marci and Buddy said:
btw,vet said to monitor his teeth , not that he has any gum infections at this time,but will need a cleaning soon.Appears he is prone to have cruddy gums and teeth,and the whole process of sedation and testing and extraction and meds makes it so expensive. vet said to not give an aB as precaution b/c it lowers his immune system. as long as there's no infection now I think I will be in denial of
what may be later . ;-)
Click to expand...

Dr. Lisa is against giving "unnecessary" ABs because the bacteria build up an immunity, it's not because the system is harmed. That's why she is so adamant about doing a C&S for UT symptoms, so you know there truly is treatable bacteria there and which AB would combat that bacteria best.

I would counter that an animal which is experiencing a chronic illness is probably already immune system compromised. Why not help them out? Gandalf gets a monthly treatment of Clindamycin and I know it helps because his breath smells less after each treatment. It's a mild AB which targets oral bacteria, so it's not like giving 10 days of Clavamox or some stronger AB.

I also saw a low number for Gandalf today - he beat Buddy, it was 30! Do I worry about him hypoing when I'm gone? Symptomatic hypo with seizures and unconsciousness, certainly not. Why not? Because he is on a proper dose and I have witnessed what happens when he does go low, he eats. That's why I agree it's important to have food available to them when you're not there. Even slightly too much insulin like Buddy got is probably not going to cause a symptomatic hypo when the insulin is Levemir. Several units too much, that's a different story. The incidence of symptomatic/they need to go to ER hypos are very very low on the board now, I feel because of the methods we promote in managing dose as well as the extent of use of Lantus and Levemir.

Are they going to rebound after a 30? Most likely they will. Is it harmful to be that low? Perhaps for an extended period, but I see food bring him up very well, although I did break out the high carb today and even a half hour later he was only 41. Vets still cringe about low numbers like that - my acupuncture vet almost had a coronary when I mentioned I was comfortable with him being at 50. To her that is a hypo number because she does ER work and sees too many cats come in who are on fast acting insulins like Humulin N or even PZI or people who double dose the cat that's on Lantus even. A 50 on one of those insulins is different than a 50 on Levemir, IMO. The incidence of hypo on Levemir in humans is also said to be less.

The worst thing about an actual overdose on Lantus or Levemir is that the hypo is going to last far longer than it would on a shorter/faster acting insulin. I think I remember it being over 12 hours for one cat on the board before it was out-of-the-woods. I don't remember the situation, if it was a double dose or what. A double dose means wife gave the cat its dose, then hubby comes along, doesn't think the cat's been given its shot and gives it also. Or vice versa, it's not always the hubby at fault :lol:
 
Wow Vicky this once agian speaks to the value of this site ...since i found this board I knew that as long as i listen to the wise suggestions here i could feel comfortable. Now, thinkning that as long as he gets his right dose he may go hypo but won't die on me is very reassuring! And congrats to Gandalf on his new dose reduction.He likes to keep you on your toes -I think Buddy may have spoken to him.
 
Experience is what speaks volumes, that's all. But I'm glad it's made you feel better.

When I first came to the board in '05 there was a lot of fear mongering about hypos. Some will say it was with good reason, but it was mostly because the insulins used then such as N and even PZI were more likely to be overdosed to start with and more likely to cause hypo by the nature of their action - say if the cat didn't eat that day, those insulins would cause them to crash sooner than Lantus or Levemir would.

Although we always caution about hypos, it's mostly when we see newbies come on with cats getting more than 3U of their insulin. That's asking for trouble because more than likely the dose was improperly increased or too high to start with, especially if it's Lantus.
 
To me this is an important update b/c i am always leaving early ,or worrying that he may die on me, even tho' i leave food out.
I've totally turned my life/schedual around to accommdate Buddy, and sometimes wish i could be away from home more than just a few hours, which i may start doing.
BTW-on a different note...if he hadn't been below 200 last night when i shot him, he most likely would not have gone hypo.
i am sceptical, b/c of this ,that the new dose of 1.25u will stick.I'm thinkng i should go back to his reg. dose (th1.5) and just make sure he is under 200 at shot time. Any thoughts ,please?
 
Unfortunately setting a cut off BG that high is counter-productive to how Lev works. You should be able to shoot at lower BGs, 175 is a perfectly shootable BG on Lev. The fact that it is not for Buddy reveals the dose at 1.5U is too high. A below 40 BG almost always calls for a dose reduction, unless other circumstances caused it, such as early shot or not eating.

It is so tempting to react to preshot BGs. The reaction is, "Crap, he was over 400 again tonight, so he must need more insulin." I've seen it time and time again, even reacted that way myself too often.

Always fighting against rebounds is no way to regulate and no way to determine optimum dose. The fact that he comes down to blues and even greens off 400s (the same thing happened on the 19th) tells me his dose is too high. Interestingly on the 19th you continued with 1.5U and he had greens off the 400s. This time he only had blues after the 432 on 1.25U.

I saw that and realized 1.5U is too much and 1.25U is better but still may be too much. A cat rebounding from a 32 would not come down to 158 off a 432 if its dose was close to optimum. From an overview of his SS his optimum dose is somewhere between 1 and 1.25U most likely.

I know you feel like you've tried every dose under the sun, but the important thing to remember is that dose trials (and yes, that's really what they are) need a systematic approach. You start with 1U and see how that goes for a week. If there are no BGs under 200, then raise to 1.1U or make it a fat1U, whatever you want to call it, but it has to be systematic. And slow.

You can see an example of what is to fast in April when you were trying 1U and raised it. Within 2 weeks you were already at 1.5U, which, as we discovered yesterday, is too much. So raising half a unit in 2 weeks was too fast because even though he was getting green numbers he was still bouncing. Raising more slowly sometimes lessens the bouncing.

Hope that helps. Or makes it clear as mud at least. :?
 
Thanks for more great explanations, Vicky! Looks like we have a lot of rebounding kitties around. The more I read posts like this and the responses to mine about Jack, I understand more of the rebounding and fine tuning needed. And the patience needed!! Also...the part about not worrying so much about the PS numbers, and looking at what happens in between is such a big part of it. Though I hate to keep poking Jack so much, or drag myself out of bed to get a midnight or later reading, I know it will all help in the big picture.

Good luck Marci and Buddy!!
 
Marci, I just came over to see if you replied and saw that Darlene dropped by. I wanted to recommend reading Darlene & Jack's thread 'cause he's got the same thing going on - his spreadsheet should look familiar! But as soon as she lowered the dose considerably he stopped bouncing/rebounding and is on his way to more predictable cycles.

I know it's hard to see them above renal threshold, but with the cycles leveling out excess peeing from that should resolve.

I hope you'll watch Jack's progress because I think he can help Buddy too. Sometimes it helps to see a plan in action before we're convinced it will work.
 
Vicky, again reading all the information you provide fits.
I am also seeing a rise in the Alley's AM/PM numbers with blues mostly in the middle.
I have to be patient with the dose as you are advising Marci. Unbelieveably, we are at, and have been at, 1 drop, (.10) and that tiny drop size matters. Either pin head size or the one that almost rolls off the top of the needle, it matters. As Marci would say, a fat drop or a skinny drop. I have gone to a skinny drop for now and will wait it out for at least 2 weeks.
Marci, I am repeating a previous post that you did everything right on the hypo. We all want to adjust the dosage for higher BG readings. It is harder to think reduction.
I totally agree with Vicky that 1.25 or slightly lower is a good place to sit for awhile.
Good luck with Buddy, and as usual, thanks Vicky.
 
thanks for the posts...Actually the reason i felt 1.5 is the dose for him is just that-beause he did have greens from the 400's off that dose, and gave only blues from the 432 off 1.25u....but, as usual,Vicky and Pam ,you make perfect sence .
I'll stick with this dose for about a week, then see where to go.Thanks so much for all your help. Pam-the fact that the .10 drop makes a difference says ALOT about the importance of consistancy when dosing, maybe i need to be even more precise,although Vicky's contraption for the exact dose is hard for
me to wrap my head around.V-maybe you can make a demo video and
put it on Youtube. :smile:
Best to you also,Darlene and Jack-I'll be watching you, our boys are so alike.
 
It is amazing that one little drop can do so much!!! I guess Alley just wants to hang onto that one drop.

These boys are certainly keeping us guessing, Marci! But I have seen that even though I'm not seeing the blues and greens yet, the bouncing is stopping and the numbers are slowly starting to come down with more yellows today. Maybe by the time we have done this dose for the 5-7 days they will go lower...who knows? but it is worth a try and does make sense when explained so well.
 
I do see he is leveling out..does he feel better when he's more even?
I have found that following the suggestions here i can't go wrong.
 
He does seem to feel and eat better when he is more level. But of course today, none of us wanted to do anything besides lay around because it is so warm and sticky! He's finally eating more now that it is a little cooler. Today was mostly spent sleeping (for him, though I did indulge in a nap myself!).
 
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